Fever in Children

Dr. Parang Mehta, MD.

Fever is a sign of disease, not a disease by itself.  Fever is usually a response of our body to some harmful process going on.  The body draws attention to several different diseases of differing types by the fever response.

Fever is common in children, and can be a sign of a serious disease.

Many types of diseases cause fever.  Some are dangerous.  Fever should not be taken lightly, especially in children less than a year old.  At this age, serious infections are more common, and diseases progress rapidly.

At any age, fever should not be ignored.  An evaluation may find only a minor or self-limited disease, but serious diseases often become visible first through fever.

What is Fever?

The normal body temperature is 35.5º to 37.5º (C), or 95.9º - 99.5º (F).  A child is said to have fever when the temperature is greater than 37.8º (C ) or 100º (F).  These temperatures are taken in the mouth.  In very young children, the temperature should be taken by a rectal thermometer.  The rectal temperature is usually slightly higher than that in the mouth.  Temperature taken in the armpit (axillary temperature) is not considered reliable.

Fever is the body's response to infections, inflammation, cancers, and several other processes that are harmful.  Fever is a response that helps the body in controlling the harmful process.  For example, when there is an infection, a fever helps in two ways.  The higher temperature slows down the growth of most germs, and some cells of our immune defense system work better.

Though fever has many causes, the most worrisome causes are bacterial infections.  Infections like pneumonia, urinary infections, bacteremia, and meningitis can present with just a fever initially.  Especially in young children and babies, these infections can progress rapidly and become serious or life-threatening.  The first step in managing a fever is always to look for signs of serious disease.

Is fever a problem?

Fever is a warning sign - an indication that something is wrong.  A quest for the cause of any fever is important, especially in young children.  The causes of fever range from trivial and self-limited viral infections to life threatening bacterial infections, cancers, and auto-immune disorders that cause long term sickness.

By itself, fever, especially in an older child, does no harm.  In younger children, it may cause loss of fluid from the body, resulting in dehydration.  Children also lose their appetite when feverish.  Between the age of 6 months and 6 years, children may suffer from fits, known as  febrile seizures  .

Another particular problem is hyperthermia -- the uncontrollable rise of body temperature to very high levels (106 F and beyond).  This condition can lead to brain damage and death, if not promptly treated.  Apart from these two specific conditions, fever, on the whole, is fairly harmless in itself.

Danger Signs

These are some pointers that you should have the child seen by a pediatrician:

Medicines For Fever

There are many drugs available to treat fever.  These drugs, called anti-pyretics, have an action on the body temperature only.  They reduce the temperature of the body, but usually have no effect on the cause of the fever.

Acetaminophen / Paracetamol: This is perhaps the most widely used drug to treat fever.  It is available as syrups, tablets, and injections.  It is considered a safe drug at the recommended doses, and is popular with pediatricians because of its safety.  The drug is most commonly used as syrup or tablet, and the effect of a dose lasts 2-6 hours.  Paracetamol is dangerous when too much is used, and not more than 5 doses should be given in 24 hours.

Ibuprofen: This is another popular drug.  It is mainly used as an anti-inflammatory drug.  However, it is effective in reducing temperature, and its effect lasts a little more than that of paracetamol.

Aspirin should never be given to children as treatment for fever

Aspirin: This drug, very popular once, is now avoided in children.  Apart from the usual side-effects like gastritis, the drug is associated with a rare, dangerous disease called Reye's Syndrome.  Children who receive aspirin while they have varicella (chicken pox) or influenza are at higher risk of getting Reye's syndrome.

Other Drugs: Many other anti inflammatory drugs like mefenamic acid and nimesulide are successful in reducing body temperature.  However, they usually offer no advantage over paracetamol and ibuprofen, and sometimes have significantly more frequent or more serious side effects.

These New Fangled Celsius Thermometers

The Fahrenheit temperature has been used for a long time, but we're now switching to the Celsius scale, which is a more rational system.  However, most of us are used to expressing fever in Fahrenheit.  To convert Celsius temperatures into Fahrenheit, multiply by 9, divide by 5, and then add 32.  Or, enter the Celsius temperature into the first box below, and click the button.

Enter the Celsius temperature:


The temperature in Fahrenheit is:


 

Dangerous Fever
Treatment of Fever

 

Last Revision: May 24, 2020